This novel was a great read; told in a bit of a choppy narrative style, with lists and magazine quizzes and living wills interspersed with the story, it still has a strong narrative arc. The storyline is informed by the author's studies in psychology and women's experiences of a cancer diagnosis -- I found it very convincing. On the back, the style is compared to Miriam Toews' A Complicated Kindness, but I just don't see that at all. This book is so much more interesting, and I don't see a great deal of overlap.

The plot is this: Leah Jordan, at 24, discovers she has breast cancer. She is in a two year relationship with Justin, who is a bit of an immature, self absorbed guy. They live together in Calgary but as the book starts they are on a road trip to British Columbia, trying to get away from the stress of daily living with cancer treatment, however they end up having a terrible fight. The title, Cleavage, thus refers both to breasts and to the divisions apparent in their relationship. Leah's experience of cancer changes the way she interacts with the world -- as the author says:

Having cancer gives Leah permission, in a sense, to do and say a lot of things that aren’t typically acceptable. Modern society really emphasizes rationality and keeping one’s emotions in check, but with Leah, I was able to really explore the dark side of a person’s psyche, and the cynical things we all think but don’t say aloud.

Leah thinks about her possible future, she waffles between hope and despair, she feels stuck in the relationship with this man who isn't all bad but just isn't the right one for her. As the book opens she breaks up with Justin - then we get a look back to see how it has come to this. By the book's end, Leah is considering leaving Calgary to move to Edmonton - that way their relationship will hopefully just fade away rather than Leah having to decisively dump him for good, but Justin, oblivious, offers to move with her. The relationship shows Leah's angst, unable to choose a strong future, unable perhaps to see one. The conclusion is ambiguous, however; will she stay with him? Will she move on? Throughout the novel we see many parts of Leah, personal moments which people often prefer to keep hidden. Her bad behaviours, unsociable thoughts, estrangement from her sister, all these things reveal her emotional trauma at going through this experience essentially alone. She tries to bridge the gap a few times, to act from a more compassionate place, but all around her is staying the same and making it hard for her to change. She doesn't seem to have any epiphanies due to her cancer, she does not suddenly see the way forward and thank cancer for making her life meaningful. But there are subtle signs that perhaps she is moving forward, beyond her passive and directionless current life. Is this due to the cancer or to the routine process of growing up? Not so clear.

The voice of the book is fantastic. Leah seems so real, and so isolated in her experience of this disease. While the story is centred around her treatment, it is more about her psychological state as she undergoes this experience, how it changes the things she has taken for granted, the things she has not committed to, like her relationship, or her working life. Her cynicism is one way of coping, of not giving in to the sentimentality that can appear in this context. At one point, Leah states:

I am sick of the pink ribbons. Slap a pink ribbon on stationery, stuffed poodles, bracelets, toques, car windshields, lapels. Silly, smiling women walking for a cure, shouting empowerment in the air, clutching their mothers and daughters to their chests. They think the pink ribbons are points – collect enough and breast cancer will disappear. They don’t understand. This game has endless levels. You can play as long as you want.

Leah's character is amazing. She is a completely believable 20-something who is coping with a terrible situation. She drifts a bit, directionless, but has a strong core within her that seems to be getting slowly drawn out by her circumstances. I loved the way she spoke, and the additions of newspaper articles, a magazine quiz, a sarcastic resume, dictionary entries, postcards, etc. between the narrative itself are intriguing, adding to the story and not at all gimmicky. They all seem like something Leah would do, keep a scrapbook of sorts of miscellaneous information along with this record of her illness and her survival. I thought the story and the form were wonderfully suited, and found Bischoff to be a supremely confident writer who has turned out a very well crafted story.

She is currently studying for her PhD in psychology - I just hope that along with her future career as a psychologist she will continue writing fiction. I enjoyed reading this novel, feeling as if I was being led through this not-so-pleasant life by someone that I could trust would give it meaning. Definitely recommended if you are interested in modern narratives about young Canadian women or about those dealing with serious illness.